Anterior cruciate ligament injury in women’s team invasion sports: Learning from established sports to understand emerging sports

The anterior cruciate ligament (ACL) injury continues to present with varying gender disparity by sport as more recently evidenced by high injury rates in the Australian Football League – Women’s (AFLW). Prevalent in many sports is the performance of sidestepping tasks in situations of high spatial and temporal constraints that could be termed a ‘worst-case scenario’ regarding the ACL injury. However, there has been inconclusive evidence if fatigue is an additional contributor to risk of ACL injury. The purpose of this thesis was three fold: (1) to examine if a team sport conditioning circuit changed the movement strategy, defined as a shift in peak joint power absorption, in elite women’s hockey players, (2) describe the current mechanisms by which ACL injuries occur in an emerging women’s sport, Australian Football (AF) and (3) consider through comparison of available information the applicability of knowledge gained from an established women’s sport (hockey) to inform recommendations for an emerging women’s sport (AFLW). Study one identified a shift of peak joint power absorption away from the hip and toward the knee during the unplanned condition and further during the unplanned condition after a sport conditioning circuit. Study two identified that a majority of in-game ACL ruptures in AFLW occurred during the first half of the season and predominantly occurred during the second quarter. Finally, the comparison of elite women’s hockey and AFLW revealed higher fitness levels and greater access to resources and support for women’s hockey that should be examined in future on their influence for the higher ACL injury incidence in AFLW. This information highlights evaluating individual movement strategy during sidestepping and the need for a more comprehensive approach to assess the whole of sporting system efficacy of development of AFLW athletes to determine if they have been physically prepared and provided the time and provisions for such preparation required to meet the demands of the elite level prior to conclusions on their inherent risk of injury as women.